[Profiles of intestinal polyparasitism in a community of the Colombian Amazon region].

INTRODUCTION: Intestinal parasite infections and polyparasitism are highly prevalent in the most vulnerable populations of developing countries due to environmental, biological and social determinants common in the transmission of parasites. Children between 1 and 15 years of age are the most affected population. OBJECTIVE: To describe the prevalence and profiles of intestinal polyparasitism in 1 to 15 year-old children from native communities in the Colombian Amazon region. MATERIALS AND METHODS: We used a non-probability sampling of 300 children between 1 and 15 years of age from several rural settlements and the main urban area of Puerto Nariño, Amazonas, Colombia, who participated voluntarily in the study. We obtained fecal samples that were analyzed by the direct method (0.85% saline solution-lugol) and the Kato-Katz technique. The most prevalent polyparasitism profiles were identified using Cohen's kappa coefficient with a 95% confidence interval. RESULTS: The prevalence of polyparasitism, defined as the presence of at least two intestinal pathogenic parasites, was 84% (95 % CI: 79.35-87.96). Polyparasitism by two or three of the following parasites: Ascaris lumbricoides, Trichuris trichiura, Blastocystis sp., Ancylostoma duodenale and Necator americanus from the Ancylostomatidae family, and Entamoeba histolytica, E. dispar and E. moshkovskii of the Entamoeba complex, had the highest prevalence. CONCLUSION: Several intestinal polyparasitism profiles were found, although in most cases fewer than six parasites were involved. Better prevalence estimations and identification of determinant factors will allow to priorize and direct resources to control these infections.

Preservación de huevos de Necator americanus con acetato de sodio-ácido acético-formalina (SAF). Estudio de caso / Preservation of Necator americanus eggs with sodium acetate-acetic acid-formalin(SAF). Case study

Resumen Introducción. La técnica de Kato Katz es el método recomendado para realizar el recuento de huevos en materia fecal y determinar la intensidad parasitaria por helmintos. La calidad de los resultados se ve afectada por la tardanza en el procesamiento de la muestra, por lo que se requiere de preservantes que faciliten la lectura posterior a las 24 horas de recolección de la muestra. Objetivo. Demostrar validez de la solución con acetato de sodio-ácido acético-formalina (SAF) como preservante de huevos de Necator americanus por medio del estudio de un caso clinico. Materiales y métodos. Descripción de caso clínico con diagnóstico de parásitos intestinales por coprológico, intensidad de la infección por la técnica de Kato Katz, evaluación de la presencia de huevos N. americanus por la técnica de Kato Katz durante 10 meses en muestra preservada en SAF y determinación de especie de Uncinaria sp. por qPCR. Resultados. Los huevos de N. americanus se conservan de manera adecuada en morfología durante los primeros cinco meses. Conclusiones. A fin de ejecutar la técnica de Kato Katz, la fijación con SAF demostró ser adecuada para el mantenimiento de la intensidad parasitaria y morfología de los huevos de N. americanus en un período de hasta cinco meses.

Abstract Introduction: The Kato Katz technique is the recommended method for fecal egg counts and determining the intensity of parasitic helminths. The quality of the results is affected by the delay in the analysis of the sample. Therefore, fixatives are necessary to make the reading easier 24 hours after sample collection. Objective: To prove the usefulness of sodium acetate-acetic acid-formalin (SAF) solution as a fixative for Necator americanus eggs by means of a clinical case study. Materials and methods: Clinical case description and intestinal parasites diagnosis by direct stool microscopic analysis and parasite infection intensity by means of the Kato Katz technique. N. americanus eggs were detected by Kato Katz method for 10 months on a SAF-fixed stool sample. Identification of Uncinaria sp. by qPCR. Results: N. americanus eggs are adequately preserved in SAF during the first five months. Conclusions: SAF fixative is suitable for Kato Katz method and proved to be capable of maintaining parasite intensity and N. americanus egg morphology over a period of up to five months.

Perfiles de poliparasitismo intestinal en una comunidad de la Amazonia colombiana / Profiles of intestinal polyparasitism in a community of the Colombian Amazon region

Resumen Introducción. Las infecciones parasitarias y el poliparasitismo intestinal son muy prevalentes en las poblaciones más vulnerables de los países en desarrollo debido a la existencia de factores ambientales, biológicos y sociales determinantes en la transmisión de parásitos. La población entre uno y 15 años de edad es la más afectada por dicha situación. Objetivo. Describir las prevalencias y los perfiles del poliparasitismo intestinal en la población de uno a 15 años de edad de comunidades indígenas de la Amazonia colombiana. Materiales y métodos. Se hizo un muestreo no probabilístico de 300 niños entre uno y 15 años de edad, procedentes de varios asentamientos rurales y de la cabecera urbana de Puerto Nariño, Amazonas, quienes participaron voluntariamente en el estudio. Las muestras de materia fecal se analizaron mediante el método directo (solución salina al 0,85 % y lugol) y la técnica de Kato-Katz. Se determinaron los perfiles más prevalentes de poliparasitismo intestinal con el coeficiente kappa de Cohen y un intervalo de confianza de 95 %. Resultados. La prevalencia de poliparasitismo, definida como la presencia de, por lo menos, dos parásitos intestinales patógenos, fue de 84 % (IC95 %: 79,35-87,96). Los casos con presencia de dos o tres agentes incluyeron los parásitos Ascaris lumbricoides, Trichuris trichiura, Blastocystis sp., los ancilostomídeos Ancylostoma duodenale yNecator americanus, así como Entamoeba histolytica,E. dispar y E. moshkovskii del complejo Entamoeba, y fueron los de mayor prevalencia. Conclusión. Se encontraron varios perfiles de poliparasitismo intestinal, aunque la mayoría de los casos involucraron menos de seis especies. Una mejor estimación de la prevalencia y los factores determinantes del poliparasitismo intestinal permitirían priorizar y orientar los recursos para su control.

Abstract Introduction: Intestinal parasite infections and polyparasitism are highly prevalent in the most vulnerable populations of developing countries due to environmental, biological and social determinants common in the transmission of parasites. Children between 1 and 15 years of age are the most affected population. Objective: To describe the prevalence and profiles of intestinal polyparasitism in 1 to 15 year-old children from native communities in the Colombian Amazon region. Materials and methods: We used a non-probability sampling of 300 children between 1 and 15 years of age from several rural settlements and the main urban area of Puerto Nariño, Amazonas, Colombia, who participated voluntarily in the study. We obtained fecal samples that were analyzed by the direct method (0.85% saline solution-lugol) and the Kato-Katz technique. The most prevalent polyparasitism profiles were identified using Cohen's kappa coefficient with a 95% confidence interval. Results: The prevalence of polyparasitism, defined as the presence of at least two intestinal pathogenic parasites, was 84% (95 % CI: 79.35-87.96). Polyparasitism by two or three of the following parasites: Ascaris lumbricoides,Trichuris trichiura, Blastocystis sp., Ancylostoma duodenale and Necator americanus from the Ancylostomatidae family, and Entamoeba histolytica,E. dispar and E. moshkovskii of the Entamoeba complex, had the highest prevalence. Conclusion: Several intestinal polyparasitism profiles were found, although in most cases fewer than six parasites were involved. Better prevalence estimations and identification of determinant factors will allow to priorize and direct resources to control these infections.